Threshold effect of hyperglycemia on the progression of microalbuminuria in type I diabetes
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:109A 1997
IDDM patients at the Joslin Diabetes Center were screened for microalbuminuria (albumin/creatinine ratio). 281 such patients were followed for 48 (36-59) months. 70 patients (25%) progressed to more severe nephropathy. The level of hyperglycemia was assessed by hemoglobin A1c (Hb A1c), averaging within 2-year intervals up to 8 years before the baseline evaluation and during follow-up. Risk of progression was strongly correlated with Hb A1c levels (< 7.0: 3.1%; 7.1-8.0: 7.5%; > 8.1: 26.5-34.4%). Antihypertensive treatment was less important.
Comment: These data further support the DCCT findings, which also suggest a low risk of progression from micro- to macroalbuminuria in patients with Hb A1c levels < 8. However, other studies have also shown beneficial effects of ACE inhibitors in patients with microalbuminuria. (David J. Leehey, M.D., Loyola University at Chicago)
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ASN 30th Annual Meeting, San Antonio
Proteinuria/Hematuria : Diabetes
CRF by problem area : Progression